Individual provider Active NPI

Kristen Anne Carlson, NP

  • Acute Care Nurse Practitioner
  • Norfolk, VA
National Provider Identifier
1235774571
Registry record updated Jul 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
0024182824 Issued in VA
Practice address
600 Gresham Dr Ste 8600
Norfolk, VA 23507-1904
Phone
(757) 388-6005
Fax
(757) 388-6006
NPI assigned
Nov 11, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 0024182824 VA
Acute Care Nurse Practitioner 363LA2100X 0024182824 VA Primary
Critical Care Medicine Registered Nurse 163WC0200X 0001276051 VA
Critical Care Medicine Registered Nurse 163WC0200X RN.417855 OH

Addresses

Primary practice location

600 Gresham Dr Ste 8600
Norfolk, VA 23507-1904

Mailing address

600 Gresham Dr Ste 8600
Norfolk, VA 23507-1904
Phone (757) 388-6005

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211221001905 VA Practitioner - Nurse Practitioner 8022409333 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Alabama School of Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sentara Medical GroupGroup PAC ID 8921903923, 1,396 clinicians

Practice addresses (Care Compare)

600 Gresham Dr
Norfolk, VA 23507-1904
Phone (757) 388-6005

Hospital & facility affiliations

  • Sentara Norfolk General Hospital Hospital, Norfolk, VA, CCN 490007

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN.417855OHMDCritical Care Medicine Registered Nurse
0001276051VAMDCritical Care Medicine Registered Nurse
0024182824VAMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sentara Medical Group CurrentSince Jan 17, 2022 Accepting new patients

Locations

600 Gresham Dr
Norfolk, VA 23507
Phone (757) 473-0055

600 Gresham Dr
#8600
Norfolk, VA 23507
Phone (757) 388-6005

850 Kempsville Rd
Norfolk, VA 23502
Phone (757) 261-0162

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1573430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720483200000",
    "number": "1235774571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 GRESHAM DR STE 8600",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235071904",
            "telephone_number": "757-388-6005",
            "fax_number": "757-388-6006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 GRESHAM DR STE 8600",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235071904",
            "telephone_number": "757-388-6005",
            "fax_number": "757-388-6006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLSON",
        "first_name": "KRISTEN",
        "middle_name": "ANNE",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-11-11",
        "last_updated": "2024-07-09",
        "certification_date": "2024-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "VA",
            "license": "0024182824",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "VA",
            "license": "0024182824",
            "primary": true
        },
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "VA",
            "license": "0001276051",
            "primary": false
        },
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "OH",
            "license": "RN.417855",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norfolk, VA

Sources for this page

Verify at the official NPI Registry.